Staff Study of the Emergency Medical Services System in the Commonwealth of Pennsylvania

House Resolution 315 of 2012 directed the Joint State Government Commission to conduct a staff study of the administrative effectiveness of the emergency medical services system (EMS) in Pennsylvania. Commission staff gathered information from a number of resources, including groups and individuals who represent the spectrum of responsibilities from top administrators to physicians to probationary EMTs. Common themes were revealed.

Despite that the overall system is often characterized as dysfunctional, comments reflect an EMS delivery system that nonetheless manages to ensure Pennsylvania residents are provided with the best services available. The primary concern of everyone involved is that necessary steps be taken to maintain and improve EMS’s effectiveness.

Findings:

Dwindling government fiscal support for services leaves providers in a continual state of uncertainty and burdened to balance limited resources against core missions. The loosely organized system of regional councils allows for local control over local conditions; however leadership, communications, evaluations, and feedback between PADOH, councils, and providers lack clarity and direction. Poor cooperation and communications between PADOH and PEMA lead to inefficiencies and confusion. Regional councils are contracted to inspect their own members. Regional councils appear to compete with their local providers for resources.

Recommendations:

Available EMS grants should focus more closely on EMS; eligibility criteria should be standardized for all applicants. The State EMS Advisory Board should be reconstituted so as to resemble the structure of similar advisory bodies. The State EMS Plan ought to be redrafted for clarity and purposes of strategic planning. PADOH needs to strengthen performance evaluation and feedback for providers with respect to the plan. The number of regional councils ought to be reduced from 15, and single county councils ought to be merged. Potential conflicts of interest must be addressed. Cooperation and collaboration within PADOH and with PEMA ought to be priority.